The population of older adults with knee osteoarthritis (OA)-related disabilities is increasing globally. However, studies regarding instrumental activities of daily living (IADL) in older adults with knee OA are limited.
OBJECTIVE:
This study investigated the psychological factors associated with IADL disability in older adults with moderate to severe knee OA.
METHODS:
A cross-sectional study was conducted on 179 patients with knee OA aged 65 years. The six-item short form of the Pain Catastrophizing Scale (PCS-6), the four-item short form of the Pain Self-Efficacy Questionnaire (PSEQ-4), and the fifteen-item Geriatric Depression Scale (GDS-15) were used to assess psychological factors. The participants were divided into IADL disabled and non-disabled groups. Binary logistic regression analyses were performed with the IADL disability status as the dependent variable. The PCS-6, PSEQ-4, and GDS-15 tools were included as independent variables in the logistic regression model.
RESULTS:
Of the 179 participants, 88 (49.1%) showed disability in conducting IADL. PSEQ-4 (odds ratio 0.90, 95%; confidence interval 0.82–0.99, 0.02) was a significant independent variable among all psychological factors.
CONCLUSION:
Even after controlling for cofounders, our study found that self-efficacy, assessed using the PSEQ-4, was related to IADL disability in older adults with moderate to severe knee OA.
BijlsmaJWBerenbaumFLafeberFP. Osteoarthritis: An update with relevance for clinical practice. Lancet.2011; 377(9783): 2115-26.
2.
Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016; 388(10053): 1545-1602.
3.
LawtonMPBrodyEM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist.1969; 9(3): 179-186.
4.
KatzSFordABMoskowitzRW, et al. Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychosocial function. JAMA.1963; 185: 914-919.
5.
WilliamsJSEgedeLE. The association between multimorbidity and quality of life, health status and functional disability. Am J Med Sci.2016; 352(1): 45-52.
6.
HennessySKurichiJEPanQ, et al. Disability stage is an independent risk factor for mortality in Medicare beneficiaries aged 65 years and older. PM&R.2015; 7(12): 1215-1225.
7.
RajanKBHebertLEScherrPA, et al. Disability in basic and instrumental activities of daily living is associated with faster rate of decline in cognitive function of older adults. J Gerontol A Biol Sci Med Sci.2013; 68(5): 624-630.
8.
PereiraDPeleteiroBAraújoJ, et al. The effect of osteoarthritis definition on prevalence and incidence estimates: A systematic review. Osteoarthritis Cartilage.2011; 19(11): 1270-1285.
9.
van DijkGMVeenhofCLankhorstGJ, et al. Limitations in activities in patients with osteoarthritis of the hip or knee: The relationship with body functions, comorbidity and cognitive functioning. Disabil Rehabil.2009; 31(20): 1685-1691.
10.
OdoleAEkediegwuEEkechukwuEND, et al. Correlates and predictors of pain intensity and physical function among individuals with chronic knee osteoarthritis in Nigeria. Musculoskelet Sci Pract.2019; 39: 150-156.
11.
SomersTJKeefeFJPellsJJ, et al. Pain catastrophizing and pain-related fear in osteoarthritis patients: relationships to pain and disability. J Pain Symptom Manage.2009; 37(5): 863-872.
12.
SinikallioSHHelminenEEValjakkaAL, et al. Multiple psychological factors are associated with poorer functioning in a sample of community-dwelling knee osteoarthritis patients. J Clin Rheumatol.2014; 20(5): 261-267.
13.
RejeskiWJMillerMEFoyC, et al. Self-efficacy and the progression of functional limitations and self-reported disability in older adults with knee pain. J Gerontol B Psychol Sci Soc Sci.2001; 56(5): S261-S265.
14.
MalyMRCostiganPAOlneySJ. Determinants of self-report outcome measures in people with knee osteoarthritis. Arch Phys Med Rehabil.2006; 87(1): 96-104.
15.
ZambonSSivieroPDenkingerM, et al. Role of osteoarthritis, comorbidity, and pain in determining functional limitations in older populations: European project on osteoarthritis. Arthritis Care Res.2016; 68(6): 801-810.
16.
DunlopDDSemanikPSongJ, et al. Risk factors for functional decline in older adults with arthritis. Arthritis Rheum.2005; 52(4): 1274-1282.
17.
DixonKEKeefeFJScipioCD, et al. Psychological interventions for arthritis pain management in adults: A meta-analysis. Health Psychol.2007; 26(3): 241-250.
18.
Barberger-GateauPRainvilleCLetenneurL, et al. A hierarchical model of domains of disablement in the elderly: A longitudinal approach. Disabil Rehabil.2000; 22(7): 308-317.
19.
EdjoloAProust-LimaCDelvaF, et al. Natural history of dependency in the elderly: A 24-year population-based study using a longitudinal item response theory model. Am J Epidemiol.2016; 183(4): 277-285.
20.
LogerstedtDSZeniJSnyder-MacklerL. Sex differences in patients with different stages of knee osteoarthritis. Arch Phys Med Rehabil.2014; 95(12): 2376-81.
21.
GeorgeLKRuizDSloanFA. The effects of total knee arthroplasty on physical functioning in the older population. Arthritis Rheum.2008; 58(10): 3166-3171.
22.
NanjoKIkedaTNagashioN, et al. Gait speed and pain status as discriminatory factors for instrumental activities of daily living disability in older adults with knee osteoarthritis. Geriatr Gerontol Int.2021; 21(8): 683-688.
23.
AlexandreTDCoronaLPNunesDP, et al. Disability in instrumental activities of daily living among older adults: Gender differences. Rev Saude Publica.2014; 48(3): 379-389.
24.
LeeMCHsuCCTsaiYF, et al. Criterion-referenced values of grip strength and usual gait speed using instrumental activities of daily living disability as the criterion. J Geriatr Phys Ther.2018; 41(1): 14-19.
25.
ZhangLGuoLWuH, et al. Role of physical performance measures for identifying functional disability among Chinese older adults: Data from the China Health and Retirement Longitudinal Study. PLoS ONE.2019; 14(4): e0215693.
26.
DonoghueOASavvaGMCroninH, et al. Using timed up and go and usual gait speed to predict incident disability in daily activities among community-dwelling adults aged 65 and older. Arch Phys Med Rehabil.2014; 95(10): 1954-1961.
27.
HermsenLALeoneSSSmalbruggeM, et al. Frequency, severity and determinants of functional limitations in older adults with joint pain and comorbidity: Results of a cross-sectional study. Arch Gerontol Geriatr.2014; 59(1): 98-106.
28.
MalyMRCostiganPAOlneySJ. Determinants of self-efficacy for physical tasks in people with knee osteoarthritis. Arthritis Rheum.2006; 55(1): 94-101.
29.
von ElmEAltmanDGEggerM, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. J Clin Epidemiol.2008; 61(4): 344-349.
30.
AltmanRAschEBlochD, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum.1986; 29(8): 1039-1049.
31.
NishigamiTMibuATanakaK, et al. Psychometric properties of the Japanese version of short forms of the Pain Catastrophizing Scale in participants with musculoskeletal pain: A cross-sectional study. J Orthop Sci.2017; 22(2): 351-356.
32.
SullivanMJLBishopSRPivikJ. The pain catastrophizing scale: Development and validation. Psychol Assess.1995; 7(4): 524-532.
33.
McWilliamsLAKowalJWilsonKG. Development and evaluation of short forms of the Pain Catastrophizing Scale and the Pain Self-efficacy Questionnaire. Eur J Pain.2015; 19(9): 1342-1349.
34.
AdachiTEnomotoKYamadaK, et al. Evaluating the psychometric properties of two-item and four-item short forms of the Japanese Pain Self-Efficacy Questionnaire: A cross-sectional study. J Anesth.2019; 33(1): 58-66.
35.
NicholasMK. The pain self-efficacy questionnaire: Taking pain into account. Eur J Pain.2007; 11(2): 153-163.
36.
SugishitaKSugishitaMHemmiI, et al. A Validity and reliability study of the Japanese Version of the Geriatric Depression Scale 15 (GDS-15-J). Clin Gerontol.2017; 40(4): 233-240.
37.
KauppilaAMKyllonenEMikkonenP, et al. Disability in end-stage knee osteoarthritis. Disabil Rehabil.2009; 31(5): 370-380.
38.
ShinkaiSWatanabeSKumagaiS, et al. Walking speed as a good predictor for the onset of functional dependence in a Japanese rural community population. Age Ageing.2000; 29(5): 441-446.
39.
NakamuraNTakeuchiRSawaguchiT, et al. Cross-cultural adaptation and validation of the Japanese Knee Injury and Osteoarthritis Outcome Score (KOOS). J Orthop Sci.2011; 16(5): 516-523.
40.
KatohMYamasakiH. Comparison of reliability of isometric leg muscle strength measurements made using a hand-held dynamometer with and without a restraining belt. J Phys Ther Sci.2009; 21(1): 37-42.
41.
NorkinCCWhiteDJ. Measurement of joint motion: a guide to goniometry. 2nd ed. Philadelphia: F.A. Davis; 1995.
42.
CharlsonMEPompeiPAlesKL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J Chronic Dis.1987; 40(5): 373-383.
43.
PeduzziPConcatoJKemperE, et al. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol.1996; 49(12): 1373-1379.
44.
VittinghoffEMcCullochCE. Relaxing the rule of ten events per variable in logistic and Cox regression. Am J Epidemiol.2007; 165(6): 710-718.
45.
KeefeFJLefebvreJCEgertJR, et al. The relationship of gender to pain, pain behavior, and disability in osteoarthritis patients: The role of catastrophizing. Pain.2000; 87(3): 325-334.
46.
MoussaviSChatterjiSVerdesE, et al. Depression, chronic diseases, and decrements in health: Results from the World Health Surveys. Lancet.2007; 370(9590): 851-858.
47.
StubbsBAlukoYMyintPK, et al. Prevalence of depressive symptoms and anxiety in osteoarthritis: A systematic review and meta-analysis. Age Ageing.2016; 45(2): 228-235.
48.
VlaeyenJWSLintonSJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: A state of the art. Pain.2000; 85(3): 317-332.
49.
ArnsteinP. The mediation of disability by self efficacy in different samples of chronic pain patients. Disabil Rehabil.2000; 22(17): 794-801.
50.
BanduraA. Self-efficacy: Toward a unifying theory of behavioral change. Psychol Rev.1977; 84(2): 191-215.
51.
KeefeFJLefebvreJCMaixnerW, et al. Self-efficacy for arthritis pain: Relationship to perception of thermal laboratory pain stimuli. Arthritis Care Res.1997; 10(3): 177-184.
52.
CollinsNJPrinsenCAChristensenR, et al. Knee Injury and Osteoarthritis Outcome Score (KOOS): Systematic review and meta-analysis of measurement properties. Osteoarthritis Cartilage.2016; 24(8): 1317-1329.
53.
FieldA. Discovering Statistics Using IBM SPSS Statistics. 4th ed. London: Sage Publications Ltd; 2012.
